ClinicalTrials.gg
RecruitingNCT05856773COMPROUpdated Sep 29, 2026

Conventionally Fractionated vs. Hypofractionated Comprehensive Nodal Irradiation for Breast Cancer Using Pencil Beam Scanning Proton Therapy

A Phase 3 interventional study of Proton Therapy in Breast Cancer, sponsored by Proton Collaborative Group. Recruiting at 9 sites in United States. Open to female participants aged 19 Years and older. Per ClinicalTrials.gov, last updated 2026-09-29.

Sponsored by Proton Collaborative Group · Phase 3, Interventional, and Treatment

From the registry’s dates

  • Started Mar 2024; still recruiting 2 years 7 months later.
Updated Sep 29, 2026Eligibility revisedGo to Updates ↓

Help build ClinicalTrials.gg — short surveys, remote interviews or testing, in your language. Take part →

Phase
Phase 3
Study type
Interventional
Enrollment
276
Allocation
Randomized
Ages
19 Years and older
Sex
Female
01

Study summary

The purpose of this research study is to learn more about the effects of using proton radiation therapy delivered over a shorter course of treatment (3 weeks) compared with a longer, standard course of treatment (5 weeks) for women with breast cancer who require radiotherapy to the breast/chest wall and regional lymph nodes.

Read the detailed description

This study is being done to see if comprehensive regional nodal radiation therapy to the breast or chest wall and regional lymph node area using proton therapy delivered with a hypofractionated approach (less treatment days) will result in rates of treatment related skin and soft tissue side effects that are non-inferior compared to conventionally fractionated proton radiotherapy regimens.

02

Conditions studied

  • Breast Cancer

Browse trials for

Keywords

  • Proton Radiation
03

In context

Breast Neoplasms

14,832 studies on the registry are indexed under Breast Neoplasms; 3,320 are open to participants now.

This study's planned enrollment of 276 is above the median of 72 across 10,903 interventional studies indexed under Breast Neoplasms.

Browse Breast Neoplasms studies →

Lead sponsor

Proton Collaborative Group is the lead sponsor of 10 studies on the registry; 6 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

The criteria were revised on the registry on Sep 29, 2026. See what changed

Ages eligible
19 Years and older
Sexes eligible
Female
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Patients with Stage I-III breast cancer who have undergone breast conserving surgery or mastectomy and have been recommended to receive postoperative radiation therapy to the breast or chest wall and regional draining lymph nodes (axilla levels I-III, SCV, IMN)
  • documented breast cancer (invasive mammary, ductal, medullary, tubular, metaplastic, mucinous, lobular, or ductal carcinoma in situ) for which treatment with radiation therapy to the breast/chest wall and comprehensive regional lymph nodes including the internal mammary chain is recommended
  • No clinical evidence or suspicion of distant disease
  • History and physical exam within 90 days prior to study registration
  • (ECOG) performance status 0, 1, or 2
  • Negative pregnancy test for women of
  • Able to begin radiation treatment within 12 weeks of last surgery or last day of chemotherapy
  • Presence of breast implants, breast expanders, tissue flap, or other breast reconstruction are allowed
  • Bilateral breast cancer is allowed if at least one side will be treated with comprehensive nodal irradiation per protocol treatment and will be recorded as the laterality receiving comprehensive nodal irradiation. If both sides will be treated comprehensively, it will be documented as such

Exclusion criteria

Exclusion Criteria:

  • Presence of skin ulceration and / or ipsilateral satellite nodules and/or edema (including peau d'orange) (T4b or T4c disease) or diagnosis of inflammatory breast cancer (T4d disease)
  • Residual gross disease detected by imaging or clinical exam with the exception of \<2cm internal mammary lymph node or supraclavicular lymph node amenable to sequential boost
  • Prior history of radiation therapy overlapping with current target volume (including intraoperative brachytherapy, interstitial catheter brachytherapy, balloon brachytherapy, external beam radiation therapy)
  • Prior history of explant surgery or implant removal due to infection or wound healing issues without subsequent implant or flap reconstruction
  • Presence of double/dual port tissue expander
  • Clinical or radiographic evidence of distant disease
  • Pregnant or breast-feeding females
  • Non-malignant systemic disease that would preclude the patient from receiving study treatment or would prevent required follow-up
  • History of connective tissue disorder (i.e., systemic lupus erythematosus, scleroderma), dermatomyositis, xeroderma pigmentosum
  • Known BRCA 1 or BRCA 2 mutation
  • Presence of an active skin rash
  • Prior history of breast cancer
  • Prior invasive non-study unless disease free for ≥ 3 years. Non-melanoma skin cancer, well-differentiated thyroid cancers, in situ carcinomas of the oral cavity, cervix, and other organs, and tumors that are not thought to impact the of the patient are permissible.
Terms in these criteria, in plain language(6)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Histologically or cytologically confirmed

The diagnosis was confirmed by looking at a sample under a microscope: tissue from a biopsy or surgery (histology), or cells from a fluid or needle sample (cytology).

Your pathology report is the document that shows this.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Life expectancy

The study doctor’s estimate of how long someone is likely to live. Criteria use it so that people can stay in the study long enough for it to answer its question.

05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
276 participants (estimated)

Study arms

  • Active comparator
    Arm A - Standard Fractionation

    50-50.4 Gy (RBE) in 25-28 daily fractions of 1.8-2.0 Gy (RBE) plus a Tumor Bed Boost (for intact breast) of 10 Gy (RBE) in 4-5 daily fractions of 2-2.5 Gy (RBE) \*\*Additional boost of 10-20 Gy (RBE) in 2-2.5 Gy (RBE) fractions to clinically involved lymph nodes or chest wall/scar allowed at the treating physician's discretion\*\*

    Radiation: Proton Therapy

  • Other
    Arm B - Hypofractionation

    40.05 Gy (RBE) in 15 daily fractions of 2.67 Gy (RBE) plus a Tumor Bed Boost (for intact breast) of 10 Gy (RBE) in 4-5 daily fractions of 2-2.5 Gy (RBE) \*\*Additional boost of 10-20 Gy (RBE) in 2-2.5 Gy (RBE) fractions to clinically involved lymph nodes or chest wall/scar allowed at the treating physician's discretion\*\*

    Radiation: Proton Therapy

Interventions

  • RadiationProton Therapy

    Pencil Beam Scanning (PBS)

06

What researchers measure

Primary outcomes

  1. To determine if the rate of grade ≥3 treatment-related skin and soft tissue toxicities with comprehensive nodal irradiation for breast cancer using hypofractionated PBS proton therapy is non-inferior to conventionally-fractionated proton radiotherapy

    This study will investigate if adjuvant comprehensive regional nodal radiotherapy to the breast or chest wall and regional lymph nodes including the axilla (levels I-III), supraclavicular (SCV), and internal mammary (IMN) lymph nodes using pencil beam scanning proton therapy delivered with a hypofractionated regimen results in rates of acute and late grade 3 or worse treatment-related skin and soft tissue toxicities that are non-inferior compared with rates in pencil beam scanning proton therapy using conventionally fractionated regimens.

    Time frame: 2 years after radiation therapy

Secondary outcomes

  1. To determine the rate of any grade ≥3 treatment-related adverse events

    Time frame: 2, 5, and 10 years after radiation therapy

  2. To determine local recurrence rates

    Time frame: 2, 5, and 10 years after radiation therapy

  3. To determine regional recurrence rates

    Time frame: 2, 5, and 10 years after radiation therapy

  4. To determine distant recurrence rates

    Time frame: 2, 5, and 10 years after radiation therapy

  5. To determine breast cancer-specific survival

    Time frame: 2, 5, and 10 years after radiation therapy

  6. To determine overall survival

    Time frame: 2, 5, and 10 years after radiation therapy

  7. To assess patient-reported quality of life

    FACT-B questionnaire

    Time frame: 2, 5, and 10 years after radiation therapy

  8. To assess patient-reported quality of life

    BREAST-Q questionnaire

    Time frame: 2, 5, and 10 years after radiation therapy

  9. To assess physician-reported cosmetic outcomes

    Physician reported cosmesis form

    Time frame: 2, 5, and 10 years after radiation therapy

Other outcomes

  1. To correlate dosimetric parameters with acute and late adverse events for the development of model dose constraints for comprehensive nodal irradiation for breast cancer using a moderately hypofractionated regimen with PBS-PT

    Time frame: 2, 5, and 10 years after radiation therapy

07

Study locations

9 of 9 sites recruiting
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Timeline

1 registry update since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Mar 2024 (actual). Primary completion is estimated for Feb 2038, 167 months after the start.

Of 328 non-industry phase 3 interventional studies under Breast Neoplasms, half reached primary completion within 79 months of starting (the median), counting those still running; a quarter within 50 and three quarters within 127. This study's planned 167 months is above that.

Counting every sponsor, half of 600 studies reached it within 59 months; a quarter within 36 and three quarters within 96.

How these figures are worked out, and which studies are left out of them.

Registered
Apr 1, 2023
First posted
May 12, 2023
StartActual
Mar 21, 2024
Primary completionEst.
Feb 2038
CompletionEst.
Feb 2041
Last update
Sep 29, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
Eligibility
1 inclusion criterion edited, 1 added, 1 removed; 1 exclusion criterion added
What changed in the criteria
Inclusion criteria
  • EditedHistologically documented breast cancer (invasive mammary, ductal, medullary, tubular, metaplastic, mucinous, lobular, or ductal carcinoma in situ) for which treatment with radiation therapy to the breast/chest wall and comprehensive regional lymph nodes including the internal mammary chain is recommended
  • RemovedDocumentation of negative metastatic workup by whole body Positron Emission Tomography - Computed Tomography (PET/CT) or by combined CT of the chest, abdomen, pelvis and Bone scan
  • AddedNo clinical evidence or suspicion of distant metastatic disease
Exclusion criteria
  • AddedPrior history of breast cancer
Sep 29, 2026
Show all 1 update
  1. Sep 29, 2026
    Eligibility 1 inclusion criterion edited, 1 added, 1 removed; 1 exclusion criterion added
    What changed in the criteria
    Inclusion criteria
    • EditedHistologically documented breast cancer (invasive mammary, ductal, medullary, tubular, metaplastic, mucinous, lobular, or ductal carcinoma in situ) for which treatment with radiation therapy to the breast/chest wall and comprehensive regional lymph nodes including the internal mammary chain is recommended
    • RemovedDocumentation of negative metastatic workup by whole body Positron Emission Tomography - Computed Tomography (PET/CT) or by combined CT of the chest, abdomen, pelvis and Bone scan
    • AddedNo clinical evidence or suspicion of distant metastatic disease
    Exclusion criteria
    • AddedPrior history of breast cancer
    + 1 other change: verification date

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT05856773
Lead sponsor
Proton Collaborative Group
Responsible party
Sponsor
First posted
May 12, 2023
Start date
Mar 21, 2024
Primary completion
Feb 2038 (estimated)
Completion
Feb 2041 (estimated)
Last update
Sep 29, 2026

Study contacts

Isabelle Choi, MD
study chair · Proton Collaborative Group

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Interested in this study?

Eligibility is decided by the study team. Share this record with your doctor or contact the team directly.

No contact was published for this record. The registry link below has the sponsor’s details.

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion